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| 17 April 2019Tips and Tricks for Young Players
2019 BALLINA SEMINAR
TIPS AND TRICKS FOR YOUNG PLAYERS
Fiona Seaton
Principal Lawyer, ILARS
17 April 2019
| 17 April 2019Tips and Tricks for Young Players
Revised ILARS Funding Policy | Counsel
▸Pre-approval no longer required to brief Counsel when ILARS-funded matter listed for con/arb
▸Counsel must be an ALSP
▸Provide WIRO with information about the listing;
- date ARD registered
- Form 1 or Form 2
- teleconference date
- date of con/arb
- name of barrister
- usually no more than 2 matters per day
| 17 April 2019Tips and Tricks for Young Players
▸A statement with all the necessary information is vital in a workers compensation claim
▸Don’t assume any answers – ask the obvious questions
▸Ask as many questions as you can
Importance of Statements
| 17 April 2019Tips and Tricks for Young Players
▸A basic statement is the best form of information to ground a grant of funding
▸Not required to be signed
▸Information can be provided within the body of the application form
Statement for an ILARS Application
| 17 April 2019Tips and Tricks for Young Players
▸Identification information; full name, DOB, current address
▸Name of employer at time of injury
▸Date of injury
▸Mechanism of injury
▸Any information that assists in understanding the nature and purpose of funding grant requested
What Should a Basic Statement Cover?
| 17 April 2019Tips and Tricks for Young Players
▸ My name is Amelia Jones
▸ My date of birth is 19 September 1985
▸ My address is 1 Happy Drive, Padstow NSW 2211
▸ I am employed as a full time diesel mechanic.
▸ My employer is ABC Pty Ltd.
▸ On 23 January 2019 I was carrying out my usual work duties at ABC Pty Ltd’s premises at 10 Banks Street Padstow when I tripped over a truck part.
▸ The fall caused me to hurt my right leg and I have not been able to walk or stand on that leg ever since.
▸ I saw my GP, Dr Catt, the same day I injured myself and she told me that I will not be able to work for at least 6 weeks.
▸ I have not received any payments of workers compensation since the injury and I do not understand my rights.
Statement example
| 17 April 2019Tips and Tricks for Young Players
▸Keep in mind requirements of the Workers Compensation Commission when you begin taking a statement, usually no oral evidence
▸WCC Rules 2011 – Rule 10.3 Material to be lodged in proceedings – a signed written statement of the evidence to be given by the worker
▸WCC Practice Direction No 3 - Information, documents and other evidence –13. Form of statements - should include work history, circumstances of injury, medical treatment and summary of ongoing effects
Tips for New Players
| 17 April 2019Tips and Tricks for Young Players
▸Psychiatric impairment rating scale (PIRS); NSW workers compensation guidelines for the evaluation of permanent impairment 4th edition
▸6 Tables - Self-care and personal hygiene, social and recreational activities, travel, social functioning, concentration, persistence and pace, employability
▸Ballas v Department of Education (State of NSW) [2019] NSWSC 234 –categories general, generic and overlapping, discretion of AMS based on history taken and clinical examination
▸Statement with detailed chronology and history critical
Psychological Injury Statements
| 17 April 2019Tips and Tricks for Young Players
▸One claim for s66 after 19 June 2012
▸Only one assessment of permanent impairment after 19 June 2012
▸When is the best time?
Whose Claim is it Anyway?
| 17 April 2019Tips and Tricks for Young Players
▸section 39 - after 260 weeks you must have 20% WPI to continue to receive weekly payments
▸section 59A - 0 – 10% WPI medicals for 2 years post weekly payments, 10% - 20% WPI medicals for 5 years, over 20%WPI medicals for life
▸section 60AA –15% WPI to access domestic assistance long term
▸WID claims require 15% WPI
▸Each threshold occurs at different milestones in the life of a claim
▸All the above has to be accommodated in one assessment
Important Considerations Affecting the Timing of the section 66 Claim
| 17 April 2019Tips and Tricks for Young Players
▸Centrelink payback
▸Centrelink and the preclusion period affecting the worker’s entitlement to future benefits
▸The threshold for future benefits eg Centrelink qualification requirements
▸Medicare and the quantum of any payback
▸What effect will any of the terms of settlement have on private health insurance
▸Will the settlement effect benefits received under an income protection policy
▸Rights arising from TPD, superannuation and life insurance policies
Important Considerations Affecting Resolution
| 17 April 2019Tips and Tricks for Young Players
Insurers are required to give notice of the following decisions from 1 January 2019;
- Dispute of liability
- Discontinuance or reduction of weekly compensation
▸What happens in other circumstances?
▸Not all work capacity decisions are contained within a section 78 notice
▸What if your client disagrees?
WCD and section 78 of the WIM Act 1998
| 17 April 2019Tips and Tricks for Young Players
Notice of a decision involving both a liability dispute and a discontinuation or reduction of weekly compensation may be combined into a single notice
• Is it a liability dispute or a WCD or both?
• What notice provisions apply?
• What if two notices are issued?
Notice and section 78 of the WIM Act 1998
| 17 April 2019Tips and Tricks for Young Players
Insurer must not discontinue or reduce payments of weekly payments to a worker unless the required period of notice has expired
• Work Capacity Decision – 3 months
• Liability Decision - payments < 1 year – 2 weeks
- payments > 1 year – 6 weeks
• What if the notice period hasn’t expired?
Section 80 of the WIM Act 1998
| 17 April 2019Tips and Tricks for Young Players
Notice provisions apply if the worker has received payments for a continuous period of at least 12 weeks
• What meaning is given to “continuous”?
• What if the worker has had periods on and off work?
Section 80(2) of the WIM Act 1998
| 17 April 2019Tips and Tricks for Young Players
Referral to the WCC of a WCD dispute to discontinue or reduce payments operates to stay the decision
• Prevents the taking of action by an insurer
• Does not apply to an internal review under s287A
• Must be referred before expiry of notice period
• What does this mean for you?
Section 289B of the WIM Act 1998
| 17 April 2019Tips and Tricks for Young Players
Worker may request an internal review
▸ Insurer must conduct review and notify within 14 days
▸May be made at any time before the referral to the WCC
▸No stay applies to internal reviews
▸What does this mean for you?
Section 287A of the WIM Act 1998
| 17 April 2019Tips and Tricks for Young PlayersTIPS AND TRICKS FOR
YOUNG PLAYERS
17 April 20192019 BALLINA SEMINAR
Principal Lawyer, ILARS
Fiona Seaton